ScienceEngineeringTechnology in the CITY

REGISTRATION

Please note that we reserve the right to limit registrations to five students per school.

Name:
Email address:

Home Address:

City: State: Zip Code:

CELL PHONE Number:

School:

YEAR IN SCHOOL: (students must be in high school)

SCIENCE TEACHER:

HOW DID YOU HEAR ABOUT SET IN THE CITY?

PLEASE LIST ANY DIETARY RESTRICTIONS YOU HAVE.